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 |   Related post: the lymphatics and perivascular lymph spaces were very ample. At the periphery, under the pia mater, the whole external sur- face of the piece was covered with a connective-tissue layer, and this sent fibers into the substance of the tissue (the pons). The ganglionic cells of the pons were pigmented, their processes stunted, their general outline deformed and surrounded by large perivascular lymph spaces. The ependyma of the fourth ventri- cle appeared thickened ; the roof appeared normal, with some epithelial thickening; with large nuclei and overgrowth of the capillary vessels. The gray substance on which this granular substance rested was atrophied ; numerous vacuous places could be seen and many Actonel 25 Mg large capillary vessels. The cellular substance of the nerve matter was pigmented, and in some places this was so extensive as to render the protoplasm opaque. Such .itrophy could be observed, with a very little difference of de- gree, principallj in the nuclei of the vagus, the glosso-pharyn- geal, the facial, and motor oculi. Scattered throughout the atrophied gray substance, in the floor of the fourth ventricle and principally around the vessels, were found numerous large amyloid corpuscles. The restiform bodies appeared normal. In the medulla the periphery of that body presented similar changes to those noticed at the periphery of the pons. Large prolongations of connective tissue went in from the surface to the medulla and principally into the pyramidal tracts. The neuroglia appeared everywhere thickened. The vascular changes were the same as mentioned in the pons, and there was seen considerable rarefaction of the nervous substance (enlargement of the perivascular lymph spaces), particularly in the region of the external arciform fibers and in the region of the inferior olives. The ganglionic elements of the olives and the inter- olivary bundles seem normal. In those portions of the medulla where the rarefaction already spoken of existed there was to be seen remarkable enlargement of the smaller blood- vessels and with thick walls. The neuroglia had a sort of fibrous look, and the amyloid corpuscles were here most abundant. In the spinal cord the changes were most noticeable in the cervical and upper dorsal portion. The periphery of the cord was encircled by a connective-tissue ring; the neuroglia was thickened and filled with nuclei : in the gray substance, particu- larly in the posterior horns, there were numerous greatly en- larged blood-vessels, and the nerve processes seemed short and broken. The central canal was encroached upon by numerous nuclei. The ganglionic cells Actonel 75 Mg Discontinued were fairly well preserved. In the spinal roots several atrophied fibers existed. The vagus, median, and external tibial presented prominent alterations, consisting of atrophy of several of the nerve bundles, with increase of the connective interstitial tissue and of alterations in the capillary vessels. In the cervical ganglion examined the atrophy of the cellular elements was quite well marked ; the blood-vessels showed marvelous examples of miliary aneurysms : the intersti- tial connective tissue was abundant. The muscular fibers of the peronei did not appear much altered, but those taken from the biceps appeared atrophied and excessively pigmented. The fibers were thin and broken down, the perimysium thickened and filled with nuclei and other evidences of degeneration (myo- sitis). The histological examination proves, before anything else, that there were prominent alterations in the central as well as the peripheral nervous system, and in the sym- pathetic as well as in the muscles. The most prominent lesions were those affecting the blood-vessels; but, at the same time, groups of nervous elements were also altered, principally in the gray substance around the fourth ventri- cle and in the gray matter of the spinal cord in its upper portions. The white substance was not entirely spared, but it appeared much less affected. The alterations in the sympathetic system were very conspicuous, while in the cerebrum and cerebellum the changes were not so conspicu- ous ; they were intensified in the pons and medulla and de- creasing as we passed into and down the spinal cord. From this point the paper is concerned with a justifica- tion of his interpretation of the lesions found, and the de- pendence of the symptoms upon them. He believes that greatest stress should be laid on the vascular changes. He says later that he truly believes the pathogenesis of shaking palsy is the alteration of the capillary vessels and the small arterioles, and this is followed by secondary changes of a degenerative nature in surrounding parenchy- matous cells. Herterich. — Female, aged sixty-six ; duration, ten years. Disease followed typhoid ; autopsy not made till thirty-six hours after death. It was noted that at the time of her death the temperature gradually rose from 37° to 40"4° 0. She had some disturbances of speech and dysphagia at this time. Eight hours after death the temperature was 39° C. There was a very strong rigor mortis. At the upper end of the cervical cord there was seen a heteropia (?) of the gray matter; in the cervical cord there was a yellowish spot of fatty degeneration in the left anterior horn ; lower down in the cervical swelling some degeneration of the left lateral column and intermediate gray matter wiis noticed ; lower down still were slight traces of sclerosis in the left anterior and right posterior columns. In the lumbar cord the gray matter at the periphery of the anterior Related links: Buy Dexamethason, Can Buy Topamax Online, Buy Temovate Online, doxycycline buy online, Differin For Acne Scars, Order Serpina Online, Noroxin 400mg, Buy Januvia Online, Detox Acai Berry, Buy Neem Oil Uk
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